CVC Highlight: My approach to an NSAID washout period in dogs

No controlled trials have been conducted to study the appropriate washout period between NSAIDs in dogs. So my recommendations are based on my experience and tend to be conservative. And my approach depends on the details of the individual case.

If the animal experienced an adverse event, I like to wait at least one week after discontinuing the offending NSAID and complete resolution of all clinical signs.

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If I'm switching to a new NSAID because of a treatment failure, then I prefer to wait one week if the dog's level of pain allows it. If the animal is in severe pain, I wait a minimum of three to four days. Other drugs such as tramadol, fentanyl (transdermal), hydrocodone, or codeine can be used if indicated to control the pain in the interim.

The washout period also depends on whether aspirin was originally given. If a client gave even one dose of aspirin, he or she should wait at least three days and, more conservatively, one week before starting a new NSAID. With long-term aspirin treatment, the client should wait at least one week before administering another NSAID. Aspirin is more likely to cause gastrointestinal adverse effects than an approved veterinary NSAID—subclinical gastric hemorrhage has been documented after a single aspirin dose. During your puppy examinations, be sure to tell clients that they should never give aspirin, ibuprofen, or naproxen.

Butch KuKanich, DVM, PhD, DACVCPDepartment of Anatomy and Physiology College of Veterinary Medicine Kansas State University Manhattan, KS 66506